This scenarios or branching path game was created for CHEST (the American College for Chest physicians) by The Game Agency to help clinicians who treat patients with uncontrolled COPD. One of the goals in building this game was to change the stigma of the drug, Nebulized LAMA, so that Pulmonologists understand it is a good solution to prescribe for many patients, not just ones at high risk. The goal was to create best practices in having conversations with patients about the drug. This Dr. Neb scenarios game showcases a series of branching dialogue, virtual conversations between doctors and patients, laid out with a storybook narrative much like a comic book with voice bubbles. The game walks through a set of interactions with different patients and different experiences with doctors asking patients a number of questions, listening to their responses, and then making recommendations based on what they hear. During each of the 4 Scenarios, players are tasked with selecting choices from each scenario they are presented and based on their responses they earn different points and are sent down different branching paths. Players must navigate conversations and identify the best response. The game includes a tug-of-war meter which moves left to "unsatisfactory" or right to "satisfactory" depending on the players' responses. This indicates to the player their progress throughout the experience. There is also a History button that allows players to go back and review their answers and see how they should have responded to follow the correct path forward. This Scenario game was built using The Training Arcade®, a game authoring tool with a library of games that allows subscribers to build games for training and education, in minutes. Creators can add images, animations, live-action video, and audio. In this case, CHEST chose to use an animated style to appeal to their audience. CHEST used some of their member physicians to define the script and The Game Agency, owners of The Training Arcade, to animate each scene. The game lives on CHEST's eLearning portal and can be accessed by all of their member pulmonologists. It is also being used at CHEST events throughout the year.

1. Learning Guild’s
DemoFest
May 20, 2020
Stephen Baer,
Managing Partner,
The Game Agency
Christina Lorenzo,
Senior e-Learning Instructional
Designer, CHEST

2. CONFIDENTIAL
CHEST

3. CONFIDENTIAL
Dr. Neb Learning Objectives
Understand and apply the
current guidelines in COPD to
the diagnosis and treatment of
new and returning patients with
COPD.

4. CONFIDENTIAL
Pulmonologists
● Complex patients
● Long hours and telemedicine
● High performers
● Exponential information
● Short attention span
● Less learning time
● Stress and burnout
Dr. Neb Audience

5. CONFIDENTIAL
● Storytelling
● Simulation
● Soft skills
Scenario-Based Learning Game
● Visual information
● Bite-size scenarios
● Safe, Fun, Engaging

6. CONFIDENTIAL
Picking the best branching path to work with, avoid complexity
Our Approach to Branching Paths
Key learning
Parallel paths Single ending
Shared start

7. CONFIDENTIAL
● Points / Meter
■ Focusing on optimal path
■ Keeping player motivated
● Leaderboard
■ Extrinsic Motivation
■ Peer status
Adding Gamification

8. CONFIDENTIAL
Our Technical Toolkit
● Scenarios game mechanic in The Training Arcade®
● HTML5
● Adobe Creative Suite
Supported by an unrestricted educational grant from Mylan NV and Theravance Biopharma, Inc.

9. CONFIDENTIAL
The Results
● Dr. Neb has been played by 465 doctors
for an average of 1.5 sessions per player
● During CHEST’s live conference the game
received high marks for being:
○ Engaging
○ Relevant to their daily practice
○ Improving performance at work
I prefer learning through gaming
as opposed to traditional lecture-
based education?
What is your overall rating?

10. CONFIDENTIAL
1) Expand learner audience and cases
2) Detective Game
3) Arcades™
Future Plans with Game-Based Learning

11. Thank You!
Stephen Baer
Managing Partner
The Game Agency
Christina Lorenzo,
Senior e-Learning Instructional
Designer, CHEST